Provider Demographics
NPI:1215104138
Name:SAUNDERS, JUDITH ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 STRADA STELL CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-4373
Mailing Address - Country:US
Mailing Address - Phone:239-597-5638
Mailing Address - Fax:239-597-5628
Practice Address - Street 1:9015 STRADA STELL CT
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-4373
Practice Address - Country:US
Practice Address - Phone:239-597-5638
Practice Address - Fax:239-597-5628
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1496182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1259Medicare PIN
S64137Medicare UPIN